Moments ago I was reminded of this seemingly trivial matter in a thread on Dentaltown.com. I’ve brought it up over the years here and there on Dentaltown. So, I thought I would write up a quick post about it on my blog.
Many dentists often use the term “simple” to describe a dental procedure. “Simple extraction” is the most common example to distinguish an extraction as non-surgical. But, it could also be used to describe a minor periodontal surgical procedure like a localized gingivectomy or even a small occlusal restoration. A “simple surgery” or “simple filling.”
I believe the word “simple” is primarily intended to reduce patients’ fears. “It’s just a simple extraction.” Certainly, any effort to decrease patient anxiety or apprehension is noble and practical. Dentists are constantly dealing with the psychology of treating patients. It’s a very thin tightrope we walk on a daily basis. We perform invasive procedures while literally getting in our patients’ faces. It’s very “personal.” So, we have learned to talk to even our adult patients as if they are children. “Just a little pinch.” “It’s a little filling.” “It’s not very deep.” “A little puff of air here.” And so on. Goo-goo, ga-ga. Don’t worry, I’m a harmless dentist. Please love me, don’t hate me.” 🙂 All well and good if it helps ease our patients through their visit.
Ain’t Nothin’ Simple.
BUT… I submit that using the word “simple” undermines your relationship with patients. “Simple” implies easy. If something is “simple” it is not worth much. “Simple” should not be expensive. And, everything we do is “expensive.” So, you communicate with your treatment coordinator or front desk in front of the patient and say, “Today’s visit will be a simple extraction.” You may see the conflicting thoughts that are very likely occurring in the patient’s head. “If it’s so simple, why does it cost so much?”
“Simple” undermines the value of the service you’re providing. “Simple” diminishes YOUR value. If it’s so “simple,” anyone could do it. It took you, at a very minimum, eight years to learn how to do that “simple” procedure. And, presumably, you’ve added to your knowledge with continuing education, not to mention your years of experience. Sure.. it’s “simple”…. for YOU.
You may dismiss my supplications here as over-analyzing the situation. And, the implications of the word “simple” may not have such an overt effect on some patients. But, I believe over the long haul, the effects may be insidious. I truly believe it will undermine your relationships and success over time.
It’s All Routine!
When you watch an Olympic or professional athlete perform, they make it all look easy. But, you’ll never hear an ice skater say, “I’m going to perform a SIMPLE quadruple-Axel-Lutz-toe-loop.” (I know very little about figure skating and imagined that amalgamation of skating moves.) It took the skater years and years to get to the point of being able to ROUTINELY perform a quadruple-Axel-Lutz-toe-loop. The skater has practiced this thousands of times. And, she 
likely busted her ass on the hard ice trying it the first few hundred times. She missed going out with friends while practicing for hours every week. No hanging out at the mall. And, her parents invested a fortune. And, now, she can nail that quadruple-Axel-Lutz-toe-loop every time, making it look simple and easy.
What did you give up (to become a dentist)? What were your friends doing when you were studying for the O-chem exam? What were your friends doing after college when you decided to go to four MORE years of school? How much have you invested in your physical facility? How much have you invested in your continuing education (be sure to count the cost of the time away from your practice)?
How many times have you “busted your ass on the hard ice” with an extraction you THOUGHT was going to be “simple?” Think about that for a moment. It is the culmination of all your experiences, good and bad, that make you the dentist you are today.
So, to no longer belabor my point and get to the solution… I eliminated the word “simple” from my dental practice. Instead we use the word, “ROUTINE.” If an extraction is non-surgical, we call it a “routine extraction.” Incidentally, if it’s a surgical extraction, we call it a “complex extraction.” Again, reducing patient fears by using friendly language is a good thing. But, we can do it without undermining the value of our services. So, remember the word, “ROUTINE.” Difficult activities are ROUTINE to those who are highly trained and experienced. “Routine” implies expertise. “Simple” implies that little to no skill is required.
OK, my fellow Dental Warriors, I think I’ve made my point! 🙂 Be proud (and realistic) about your skills. Unwitting self-deprecation has no place in your dental practice! Your skills are not “simple.” Comport yourselves accordingly. Give your services the dignity and value they deserve.
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Totally agree with this. As a dentist with a lot of surgical experience, the ONLY “simple” extractions are the baby teeth that patients self-extract, and even then sometimes they leave root fragments.
But remember that extracting a tooth is an amputation. I find most people have a hard time using those two words–simple and amputation–in the same sentence.
Deciduous teeth that are not mobile can be tricky (and fragile). I agree it’s an amputation of a body part. But, even dentists are guilty of perpetuating the lay person’s perception that teeth are disposable and removing them is like getting your hair cut.
Ah, but as one who had a flat top haircut for almost 25 years, I can also assure you that even a haircut is not a haircut is not a haircut. Just TRY to cut one! It takes some real skill to be able to cut one well. Very few can do it excellently. The big difference, though, is that if you screw up a haircut, it will grow back eventually. Teeth, not so much.
I also think about my eye surgery. I had a lens replacement. Took him all of 8 minutes start to finish to do it–less time than it takes us to do an occlusal restoration–the most routine thing we do! I DARE anyone to call a lens replacement “simple!” Do you know the skill it takes to be able to routinely do lens replacements in 12 minutes? “Routine?” Absolutely. “Simple?” I don’t think so. What we do is very similar.
I’m reminded of the value of attorneys. We pay them for their knowledge base to solve a problem in 20 minutes what it would take a lay person a month to do.
Also, thanks for the figure skating reference – it is SUCH hard work, as our daughter can attest. She’s still only doing single jumps after two years of practice, yet the champions make it look so easy!
Hi Trish,
Thanks for your comments. You reminded me of something I read in the book Selling the Invisible: A Field Guide to Modern Marketing
by Harry Beckwith.
The passage in the book was called, “The Picasso Principle.” In a nutshell it goes like this:
A woman was strolling the streets of Paris and spotted Pablo Picasso doing pencil sketches while sitting at a sidewalk cafe. She stopped and asked him, “Would you sketch me and I’ll pay you accordingly?” He obliged her and in just five minutes produced a remarkable likeness of her. She asked, “How much do I owe you?” Picasso replied, “2,000 Francs.” “Two thousand Francs?? It only took you five minutes!” Picasso smiled, “No. It took my whole life.”
Moral of the story: Don’t charge by the hour. Charge by the year.
I agree with that an experienced dentist can make a difficult extraction routine. It’s about how many times we’ve been there before and solved the puzzle of how do I get this thing out. That’s the value of expereience. I always tell the patient that I expect the extraction to be ‘straightforward’ and describe it in a it’s going to be routine, minimal discomfort if any sort of way. I hadn’t thought much how simple extraction really sounds but now that you’ve brought it to my attention I will eliminate that phrase. By the way, I enjoy the Dental Warrior topics very much. Best To All, Alvaro
Hi Alvaro,
Funny… I also use that word, “straightforward.” 🙂
Thanks for your comments!
Mike
From a hygienist’s point of view I see a similar terminology problem with the word “cleaning”. Patients often hear “regular cleaning” and “deep cleaning” without understanding, or appreciating, the real difference. Maybe I should start using the phrases “routine cleaning” and “complex cleaning”. I try to avoid using the phrase “deep cleaning” and instead focus on terms like disease, infection, non-surgical options, etc. I also use the DDS GP to educate, which helps me sell the real value of what we are offering.
Great points, Mark. Another way to describe scaling that I’ve used is something like, “You’ve got deposits down on the ROOTS of your teeth. A routine cleaning doesn’t reach that far.”
Thanks for chiming in!
I JUST NEED A CLEANING
almost every word in this is wrong.
“JUST” means ‘it is an unimportant thing’
“NEED” means something undesired — a necessary evil
“A” makes any service a commodity — fungible and generic
“CLEANING” reduces a professional service to the level of scrubbing a sink
how often do YOU say “Mrs. Jones, you JUST NEED A CLEANING?”
Very true, Neil.
I bristle whenever I walk in for a periodic exam, and the patient says, “What do the x-rays say?” My standard reply (and I swear I do this with a big smile on my face): “So far in 25 years of practice, I haven’t heard x-rays talk. But, I will read and interpret them. Along with an actual exam with my eyes and hands, I can render a diagnosis.” 🙂
Yesterday I was to extract #14- broken to roots. I almost told the pt “it’s just a simple extraction”. Remembered this article and caught myself just in the nick of time. I said that I would do my best. Tooth came out easily and I looked like a superhero 😛 🙂
Thanks!
I could not agree with you more,Mike.
Much of the problem stems from the fact that many dentists participate with insurance companies which, by definition, devalues our work. When the ADA agreed to issue annual codes so that the insurance companies could ‘pay’ the dentist, it was the kiss of death for our profession. A toothache in the middle of the night: $1000. We restore broken front tooth so that you can go to an interview for the job of your life: $1,000.
THIS is capitalism.
As long as you are not collecting your full fee for your work i.e. participating with insurance, you are devaluing your work. I haven’t worked with an insurance company in a quarter of a century.
Thanks, Gerald! I agree!
Thank you for this nice blog. I love your blogs. I agree with you 100%.